A garden suite is a portable, self-contained living space installed on a lot adjacent to an existing single-family home. This allows individuals or couples with disabilities to be independent while living in close proximity to those who can provide care should they need it.

This guide helps seniors (their families and caregivers) assess their own unique circumstances including using stairs, moving around the house, doing laundry and answering the door.

Slide 1: Introduction

{MUSIC plays.}

{VISUAL: Title appears on the screen: Housing Options for People Living with Dementia: Modifications for Private Homes}

V.O.: “Welcome to Canada Mortgage and Housing Corporation’s webcast on Housing Options for People Living with Dementia: Modifications for Private Homes.”

{VISUAL: A series of photographs FADE IN below the title, illustrating what ‘home’ means to different multi-generational families – e.g. an elderly couple play the piano in their living room; a multi-generational family share a laugh at the dinner table; a young woman shares a smile with an older woman in a wheelchair; etc.}

V.O.: “For most Canadians, ‘home’ is the place where we feel welcome, safe and secure. This is especially important for people who are living with dementia.”

Slide 2: Introduction

{VISUAL: As the Voice-Over continues, the photographs FADE INTO SOFT FOCUS and a BULLET LIST of text appears over them.}

[TEXT ON SCREEN:

Dementia causes a loss of mental functions over time

One in 13 people over age 65, and one in three over 85, will experience dementia

Over the next 20 years, cases of Alzheimer’s and dementia are expected to double]

V.O.: “Dementia refers to a variety of neurological conditions that cause the loss of mental functions over time. According to the Alzheimer’s Society of Canada, one in 13 people over the age of 65, and one in three over the age of 85, will experience at least some form of dementia. As Canada’s population continues to age, over the next 20 years, the number of people diagnosed with Alzheimer’s disease and other forms of dementia is expected to double in number.”

Slide 3: Introduction

{VISUAL: The photographs and text FADE OUT, and three new photographs FADE IN, showing examples of people with dementia who are living independently at home – e.g. an elderly couple cook a healthy meal in a well-lit and open kitchen; an elderly woman gardens in an attractively-landscaped backyard; an elderly man uses a handrail to walk safely upstairs; etc.}

V.O.: “Assisting people with dementia to remain as safe and independent as possible in their home or community poses unique challenges to their housing, health and support needs. Thankfully, there are a number of relatively simple changes that can be made to almost any home to make them safer, more comfortable and more familiar for anyone who is living with dementia – and to assist their families, friends and caregivers in meeting their daily needs.”

Slide 4: The Guide

{VISUAL: The photographs and title FADE OUT, and an image of the front cover of the Housing Options for People Living With Dementia guide FADES IN on the centre of the screen. As the Voice-Over continues, the image of the guide SLIDES to the left side of the screen, and a BULLET LIST of text FADES IN beside it.}

[TEXT ON SCREEN: THE GUIDE

Simple, practical tips for people with dementia, caregivers and housing providers

Create a living environment that:

Increases safety, security and belonging

Maximizes abilities and focuses on strengths

Encourages independence and involvement in life]

V.O.: “CMHC’s Guide to Housing Options for People Living with Dementia offers simple and practical advice on home adaptations, renovations and design suggestions to help people living with dementia, and their caregivers or housing providers, create a living environment that:

Increases safety, security and a sense of belonging;

Maximizes abilities and focuses on strengths; and

Encourages independence and involvement in life.”

Slide 5: The Guide

{VISUAL: The bullet list fades out, and a new bullet list fades in.}

[TEXT ON SCREEN: THE GUIDE

Straightforward, room-by-room approach

Familiar, home-like, easy-to-understand environment

Person-centred approach to each person’s unique journey

Include the person living with dementia in making decisions]

V.O.: “For people living in private homes, the Guide uses a straightforward, room-by-room approach to suggest a range of design elements, adaptations and modifications that can help people living with dementia become safer, more independent and more comfortable.”

“The physical environment plays a big role in the quality of life of people with dementia. An environment that is familiar, home-like and easy to understand can help reduce feelings of agitation, aggression, depression and social withdrawal.”

“When adapting a private house to meet the needs of someone with dementia, a person-centred approach that takes their individual tastes and requirements into account can dramatically improve their quality of life, and help them adapt more easily to changes in their home. If possible, the person living with dementia should also be included in deciding which home modifications to undertake, to lessen the chances for confusion or irritation.”

Slide 6: Lighting

{VISUAL: The photograph and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating lighting-related home adaptations related to a person living with dementia – e.g. a kitchen flooded with natural light; a close-up of bright task lighting or curtain rails that extend beyond the width of a window; etc.}

[TEXT ON SCREEN: LIGHTING

One of the most important home adaptations

Essential for reading, cooking, eating

To maximize indoor lighting:

Extend curtain rails beyond windows

Remove furniture, objects and landscaping from windows

Avoid hanging lace curtains

Provide different types of lighting (overhead, natural, task)

Ensure switches contrast with walls

Replace burned-out light bulbs]

V.O.: “One of the most important adaptations for people living with dementia is to maximize the amount of natural and artificial light in the home. Good lighting is especially essential in areas where people spend a lot of time or carry out complex tasks, such as reading, cooking or eating. To increase the amount of indoor light in a home, try to:

Extend curtain rails beyond the windows, to let in as much natural light as possible;

Remove any indoor furniture or objects, or outdoor landscaping, that might block the windows and keep light out;

Avoid hanging lace curtains, as these can cause shadows or misperceptions;

Use a variety of different types of lighting, including overhead lights, natural light and task lighting;

Use coloured light switch plates to contrast light switches with the wall around them, so they’ll be easier to find and identify; and

Replace any burned-out light bulbs as soon as possible.”

Slide 7: Doors

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating door adaptations related to a person living with dementia – e.g. a door painted in a contrasting colour to the wall around it; a door that’s fully-opened into a room; a door with a sign hung at eye-level; etc.}

[TEXT ON SCREEN: DOORS

Clearly visible and easy-to-use

Painted in a contrasting colour

Open fully to interior of the room

Avoid sliding doors

Re-hang bathroom doors to open outward

Use signs to identify doors to key rooms]

V.O.: “Another area of the home where a few small changes can make a big difference is in the doors and doorways. Clearly visible and easy-to-use doors are critical for helping people with dementia to find their way safely and easily around their home. Some other tips to make doors easier for seniors or someone with dementia to use include:

Paint doors in a different colour than the surrounding walls, so they’ll be easier for someone living with dementia to find and use.

Doors should also open fully, so that the interior of the room is clearly visible from the hallway.

Avoid sliding doors, as people living with dementia can find them hard to use.

If possible, re-hang bathroom doors to open outward, to allow for easier access in case someone falls against the door from the inside.

Plus, use signs placed at eye-height to identify the doors to key rooms, such as the bathroom or kitchen. Signs like ‘STOP’ written in big, bold letters can also be used for doors that are not meant to be accessed.”

Slide 8: Signs

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating indoor signs related to a person living with dementia – e.g. a door with a sign that says ‘STOP’ or which has a label and a directional graphic or photograph on it; etc.}

[TEXT ON SCREEN: SIGNS

Consistent in style

Use a contrasting colour

Mounted 1.2 metres from the floor

Use capital and lower-case letters, with a graphic, photo or direction

Contrast between words and background]

V.O.: “When using signs to help someone with dementia find their way around a home, make sure the signs are:

Consistent in style, and coloured to contrast with the door or wall;

Mounted no higher than 1.2 metres from the floor;

Written with capital and lower-case letters, and perhaps a graphic, photograph or directional signage if a location isn’t obvious; and

Made using a visible contrast between the words and the background (such as light lettering on a dark background).”

Slide 9: Floors

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating flooring adaptations related to a person living with dementia – e.g. consistent flooring flowing from one room to another; a close-up of low-pile carpeting; etc.}

[TEXT ON SCREEN: FLOORING

Avoid changes in colour, tone or patterns

Avoid shiny floors

Install low-pile carpeting to cushion falls

Remove threshold strips and doormats

Avoid large speckles and sparkles

Use similar light-reflecting values]

V.O.: “The flooring in the home should also be as consistent as possible, as changes in colour, tone or patterns could be misinterpreted as steps, and increase the risk of falling. In addition, wherever possible, try to:

Avoid shiny floors, as they can cause glare or be confusing or slippery;

Install low-pile carpeting to help cushion floors in case of falls;

Remove threshold strips and doormats, as they can cause people to stop or falter;

Avoid linoleum, carpet or vinyl flooring that has large specks or sparkles, as people with dementia may attempt to pick up the specks; and

If there are different flooring types adjacent to each other, make sure they have light-reflecting values that are as similar as possible.”

Slide 10: Stairs

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating stair adaptations related to a person living with dementia – e.g. an elderly person using a handrail to safely walk up some stairs; a close-up of stair edges outlined with bright tape or rubber treads; a stairway with handrails running the full length; etc.}

[TEXT ON SCREEN: STAIRS

Install solid, reinforced handrails on both sides

Outline edges with brightly-coloured paint or tape

Install rubber treads or non-skid adhesive strips

Avoid tonal changes at the top and bottom of stairs]

V.O.: “Stairs can be one of the most dangerous areas of a home for seniors and people living with dementia. To make stairs safer and easier to navigate:

Avoid strong tonal changes in the flooring at or near the top and bottom of the stairs, as a change in tone could be perceived as a hole, and lead to fear or confusion.”

Slide 11: Handrails

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating handrail adaptations related to a person living with dementia – e.g. a close-up of a handrail with a knob or inward turn at the end; etc.}

[TEXT ON SCREEN: HANDRAILS

Easiest and most common modification

Easily graspable

Rounded ends, non-slip surface and diameter of approximately 4 centimetres

Secured firmly to the wall

Include a knob or inward turn at each end]

V.O.: “In fact, handrails are one of the easiest and most common modifications that can be made around the home. To assist both people living with dementia and their caregivers, all handrails should be:

Easily ‘graspable,’ with rounded ends, a non-slip surface and a diameter of around 4 centimetres.

Handrails should also be secured firmly to the wall, to allow for a firm grip and to support the weight of anyone using them.

Plus, be sure to install a knob, inward turn or other feature at each end of the rail, to indicate where the handrail stops.”

Slide 12: Kitchens

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating kitchen adaptations related to a person living with dementia – e.g. an accessible kitchen with contrasting colours and lots of natural light; open or glass cabinets and shelves; a close-up of an automatic shut-off sensor on a stove or oven; etc.}

[TEXT ON SCREEN: KITCHENS

Choose traditional-looking equipment and appliances

Keep utensils and equipment visible and easily reachable

Install heat, smoke and automatic shut-off sensors

Add strip lighting above surfaces and spotlights for work areas

Avoid speckled surfaces

Choose sound-absorbent surfaces

Use same heights for stove and countertops]

V.O.: “For many families, the kitchen is the heart of the home, and an essential part of a healthy, active and engaged lifestyle. It is also one of the most difficult rooms to adapt for people living with dementia. When modifying a kitchen for someone with dementia:

Choose traditional- or familiar-looking equipment and appliances;

Make sure the utensils and equipment the person uses most often are visible and easily reachable;

Install heat and smoke sensors that can automatically shut off the stove, oven or other hazardous appliances;

Maximize the amount of light by installing strip lighting above kitchen surfaces and adding spotlights for work areas;

Avoid speckled surfaces that could be mistaken for crumbs or bugs;

Minimize noise levels by using sound-absorbent surfaces where appropriate; and

Try to make sure the stove and countertops are at an even level, as it may be difficult for someone with dementia to judge differences in height.”

Slide 13: Bathrooms

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating bathroom adaptations related to a person living with dementia – e.g. a bathroom with contrasting colours, grab bars, a handheld showerhead and shower seat; etc.}

[TEXT ON SCREEN: BATHROOMS

Traditional, easy-to-operate fittings

Contrasting colours for toilet seat, bowl and floor

Install non-slip flooring with no threshold strips

Add handrails in a contrasting colour

Maximize natural and overhead light

Install handheld showerhead

Free-standing shower seat and barrier-free shower]

V.O.: “After kitchens, bathrooms are the most difficult room for people with dementia to interpret, since the design of bathrooms and their fittings has changed so much. When adapting the bathroom, try to choose fittings that look as traditional, and are as easy to operate, as possible. Other changes or features that can make the bathroom safer for someone living with dementia include:

Using contrasting colours to visibly separate the toilet seat from the bowl and the floor;

Installing non-slip flooring, and avoiding threshold strips or making sure they blend in with the adjacent hall or bedroom flooring;

Adding handrails in a colour that contrasts with the walls and floor;

Maximizing natural light, and positioning overhead lights where they will minimize shadows and won’t shine in anyone’s eyes;

Installing a handheld showerhead, so the person with dementia can see where the water is coming from and have some control over it; and

Purchasing a free-standing shower seat if needed, and making sure the entry to the shower is barrier-free.”

Slide 14: Bedrooms

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating bedroom adaptations related to a person living with dementia – e.g. a peaceful-looking bedroom with lots of natural light; a close-up of a drawer with an easy-to-use handle and a sign labelling the contents; etc.}

[TEXT ON SCREEN: BEDROOMS

Quiet and familiar

Ensure plenty of light

Choose wardrobes with open or glazed doors

Use signs to identify contents of drawers]

V.O.: “Bedrooms should be quiet and look as familiar as possible. They also need to have a lot of light. When choosing furniture, look for wardrobes with clear, open or glazed doors, that make it possible to see what’s inside. Placing signs on drawers can also be helpful, to identify what each drawer contains.”

Slide 15: Dining Rooms

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating dining room adaptations related to a person living with dementia – e.g. a dining room with consistent, non-shiny flooring, contrasting colours and lots of light; etc.}

[TEXT ON SCREEN: DINING ROOMS

Same or similar flooring throughout

Traditional furniture that contrasts with the floor

Use signs to label furniture

Plenty of natural and artificial light

Tableware that contrasts with table and isn’t childish

Plates, bowls and cutlery modified for physical disabilities]

V.O.: “To enhance safety and minimize confusion in the dining room:

Use the same or similar flooring throughout the room;

Choose traditional furniture that contrasts visually with the floor, and use signs to label furniture like the sideboard or buffet, to indicate what they’re used for;

Make sure there’s plenty of natural and artificial light, to promote a positive mood and encourage eating;

If new tableware is required, make sure it contrasts with the table, and don’t choose designs with distracting or childish patterns; and

Consider buying plates, bowls and cutlery that have been modified to assist those with physical disabilities, like large-handled cutlery for people who have difficulty grasping.”

Slide 16: Living Rooms

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating living room adaptations related to a person living with dementia – e.g. an open-concept living room with consistent flooring, contrasting colours, traditional furniture, a fireplace and lots of light; etc.}

[TEXT ON SCREEN: LIVING ROOMS

Traditional furniture and fittings that contrast with the floor and give strong cues

Maximize natural and artificial light

Remove curtains, trees or shrubs that block the windows

Add a focus like traditional fireplace with mantel

Change or add cushions for visibility

Cover TV when turned off]

V.O.: “For the living area:

Choose traditional furniture and fittings that contrast with the floor and give strong cues to the purpose of the room;

Maximize natural and artificial light levels, and make sure there are no curtains, trees or shrubs blocking the windows;

Give the room a focus point other than a TV, like a traditional-looking fireplace with a mantelpiece;

Consider changing or adding cushions to make the furniture more visible; and

Use a cover or cupboard to cover the television when it’s switched off, as TVs can alarm people with dementia by showing a reflection of their faces.”

Slide 17: Outdoor Spaces

{VISUAL: The photograph(s) and bullet list FADE OUT. A new BULLET LIST of text FADES IN, along with a photograph (or photographs) illustrating outdoor space adaptations related to a person living with dementia – e.g. an elderly woman gardening or a senior couple enjoying their backyard; etc.}

[TEXT ON SCREEN: OUTDOOR SPACES

Pleasant or interesting view

Level and barrier-free access (with ramps if needed)

Comfortable sitting area that’s visible from the door

Terraces, patios, balconies and other “halfway outdoor” areas

Outdoor interests and activities]

V.O.: “For people living with dementia, outdoor spaces can be just as important as the indoors. For instance, many people with dementia spend a lot of time looking out the window. So try to make sure there’s something pleasant and attractive for them to look at, like a view of the garden or an area where something is happening.”

“Spending time in the outdoors can also be important for both health and overall quality of life. To maximize opportunities for getting outside:

Make sure the access to the outdoors is level and barrier-free, and provide ramps where they’re needed;

Place a comfortable chair or sitting area outdoors, in a spot that’s clearly visible from the door or windows;

Take advantage of terraces, patios or balconies as “halfway outdoor” areas that still feel safe and protective; and

Come up with things to do in the yard or garden as a way of encouraging people to go outside.”

Slide 18: Conclusion

{VISUAL: The photograph(s) and bullet list FADE OUT, and the original multi-generational family ‘home’ photographs from Slide #1 FADE IN. The title reappears on the top of the screen: Housing Options for People Living With Dementia: Modifications for Private Homes}

V.O.: “Dementia is a serious condition, both for those who live with it, as well as for their families, loved ones and caregivers. But with some forethought and a few modifications, any house can be designed, renovated or adapted to help someone living with dementia remain comfortable, safe, independent – and in their own home – for as long as possible.”

Slide 19: Find Out More

{VISUAL: The photographs and title FADE OUT, and an image of the Front Cover of the Housing Options for People Living With Dementia guide FADES IN on the left side of the screen. On the right side of the screen, the url for CMHC’s website appears.}

[TEXT ON SCREEN: cmhc.ca/accessible housing]

V.O.: “For more information about the Housing Options for People Living With Dementia guide, or for a full list of other resources that are available to assist both housing providers and caregivers in designing, renovating or adapting a home to meet the needs of people living with dementia, visit the CMHC website at cmhc.ca/accessiblehousing”

{VISUAL: The screen fades to white. The bilingual CMHC logo and “Home to Canadians” tagline appear on the screen, with the standard Disclaimer Text in small-print beneath it.}

[TEXT ON SCREEN: The information in this publication is a result of current research and knowledge. It is not intended for the content to be relied upon as professional or expert advice or opinions. Readers should evaluate the information, materials and techniques cautiously for themselves and consult appropriate professional resources to see if the information, materials and techniques apply to them. The images and text are guides only. Project and site-specific factors (climate, cost, aesthetics) must also be considered.]

{VISUAL: The screen fades to white as the Canada Wordmark fades in. The Canada Wordmark fades out, and the icons for Flickr, Twitter and YouTube appear on the screen, along with the CMHC website address: cmhc.ca}